Urabe Yuji, Oka Shiro, Ishikawa Hideki, Nakajima Takeshi, Tanakaya Kohji, Takayama Tetsuji, Ishida Hideyuki, Tanaka Shinji
Department of Gastroenterology, Hiroshima University Hospital, Japan.
Department of Molecular-Targeting Prevention, Kyoto Prefectural University of Medicine, Japan.
Intern Med. 2025 May 15;64(10):1459-1469. doi: 10.2169/internalmedicine.4471-24. Epub 2024 Oct 25.
Objective Screening and surveillance methodologies for Lynch syndrome (LS) in Japan. This study assessed the changes in LS knowledge and practice trends. Methods In 2020 and 2022, 2 questionnaire surveys were administered to 3,574 councilors of the Japanese Society of Gastroenterology to assess changes in LS-related knowledge and practices. Materials Each questionnaire item was analyzed by comparing responses between the first and second surveys to determine the proportion of doctors selecting each option relative to the total number of respondents. The responses from doctors who completed both surveys were analyzed to assess the temporal changes in their responses. Results The second survey showed a significant increase in the awareness of universal tumor screening (UTS), proportion of doctors selecting UTS for primary LS screening, use of BRAF V600E testing for chemotherapy selection, and number of newly diagnosed LS patients per doctor over the last three years. In addition, the number of patients currently under surveillance by doctors has also increased. Doctors who intensified primary screening for LS between surveys reported a greater increase in newly diagnosed cases. However, the rise in UTS suggests a potential bias from doctors with heightened interest in LS, which may have influenced the findings. Conclusion The number of newly diagnosed and currently monitored patients with LS in Japan has been increasing, likely due to expanded screening practices. However, the potential bias introduced by the increased adoption of UTS should be considered when interpreting these results.
目的 日本林奇综合征（LS）的筛查和监测方法。本研究评估了LS知识和实践趋势的变化。方法 2020年和2022年，对日本胃肠病学会的3574名委员进行了2次问卷调查，以评估LS相关知识和实践的变化。材料 通过比较第一次和第二次调查的回答，分析每个问卷项目，以确定选择每个选项的医生比例相对于总受访者数量的情况。对完成两次调查的医生的回答进行分析，以评估他们回答的时间变化。结果 第二次调查显示，在过去三年中，普遍肿瘤筛查（UTS）的知晓率、选择UTS进行原发性LS筛查的医生比例、使用BRAF V600E检测进行化疗选择的情况以及每位医生新诊断的LS患者数量均显著增加。此外，目前接受医生监测的患者数量也有所增加。在两次调查之间加强LS初级筛查的医生报告新诊断病例增加幅度更大。然而，UTS的增加表明对LS兴趣较高的医生可能存在潜在偏差，这可能影响了研究结果。结论 日本新诊断和目前正在监测的LS患者数量一直在增加，可能是由于筛查实践的扩大。然而，在解释这些结果时应考虑UTS采用增加所带来的潜在偏差。
